Prevención del cáncer de piel en preescolares: experiencia parental en fotoprotección

Fundamento: como promedio se han generan tres millones de casos de cáncer de piel a nivel global en los últimos años. Esta situación ocurre entre otras razones por la constante exposición a la radiación solar y la no aplicación de fotoprotección. Objetivo: determinar la experiencia parental en fotoprotección durante la infancia. Método: se realizó un estudio etnográfico en la Unidad Educativa de la Parroquia San Juan del Cantón Riobamba, Provincia Chimborazo, durante el período de estudio de octubre 2022 a octubre 2023. Se realizaron 14 entrevistas a cuidadores de preescolares, los que fueron escogidos a través del muestreo no probabilístico. Se dispuso de dos técnicas de recolección de la información: el autorreportaje y la entrevista semiestructurada. Resultados: se describieron cada una de las categorías que emergieron en el estudio según el nivel de frecuencia: fotounidad, fotoexperiencia-conocimiento y fotosanidad. Se construyó un mapa representacional en el cual se determinó que la familia en sí representa la fotounidad, mediante la participación de todos sus miembros en la protección de los efectos nocivos del sol. La sombrilla que cubre a la familia refleja la fotoexperiencia-conocimiento adquiridos por los cuidadores, que actúan como protección al daño solar mediante medidas preventivas y de cuidado. El sol y sus rayos solares simbolizan la fotosanidad, que corresponde a la exposición a rayos solares y sus efectos nocivos para la salud. Conclusiones: la implementación de medidas de fotoprotección desde edades tempranas resulta de vital importancia para la prevención del cáncer de piel, por lo que es necesario brindarles a los padres información adecuada sobre los riesgos solares y las medidas preventivas.

Foundation: on average, three million cases of skin cancer have been generated globally in recent years. This situation occurs among other reasons due to constant exposure to solar radiation and non-application of photoprotection. Objective: determine parental experience in photoprotection during childhood. Method: an ethnographic study was carried out in the Educational Unit of the San Juan Parish of the Cantón Riobamba, Chimborazo Province, during the study period from October 2022 to October 2023. 14 interviews were carried out with preschool caregivers, who were chosen through of non-probabilistic sampling. Two information collection techniques were available: self-report and semi-structured interview. Results: each of the categories that emerged in the study were described according to the level of frequency: photounity, photoexperience-knowledge and photosanity. A representational map was constructed in which it was determined that the family itself represents photounity, through the participation of all its members in protecting themselves from the harmful effects of the sun. The umbrella that covers the family reflects the photo-experience-knowledge acquired by the caregivers, which act as protection from sun damage through preventive and care measures. The sun and its solar rays symbolize photosanity, which corresponds to exposure to sunlight and its harmful effects on health. Conclusions: the implementation of photoprotection measures from an early age is of vital importance for the prevention of skin cancer, so it is necessary to provide parents with adequate information about sun risks and preventive measure.

Conocimientos, hábitos y aptitudes en fotoprotección para prevenir el cáncer de piel

Fundamento: El cáncer de piel es una de las neoplasias más frecuentes, con un considerable aumento en las últimas dos décadas. Las campañas de fotoprotección han tenido un impacto positivo en la población y permiten a las personas sanas el cuidado de su piel y la prevención del cáncer. Objetivo: Describir los principales resultados obtenidos en los estudios científicos relacionados con los conocimientos, hábitos y aptitudes en fotoprotección para la prevención del cáncer de piel en población de riesgo mayor de 18 años. Método: Se realizó una revisión sistemática en las bases de datos Scopus y Pubmed en (inglés), Scielo y CUIDEN en (español), con perfil de acceso desde la biblioteca electrónica de la Universidad de Granada en el período de estudio comprendido desde mayo de 2018 hasta julio de 2022. Se elaboró la pregunta guía a través del acrónimo PICOT, términos de búsqueda y se utilizaron los descriptores en Ciencias de la Salud y del Medical Subject Headings, respectivamente. Resultados: Conocer las conductas de riesgo y de protección es útil para orientar las intervenciones individuales o a nivel comunitario para disminuir la morbilidad asociada a la exposición solar. Se ha demostrado que las campañas de prevención del cáncer de piel son eficaces y rentables. Los médicos de atención primaria juegan un papel importante en la prevención del cáncer de piel. El asesoramiento sobre factores de riesgo modificables y estrategias para evitar el sol, en pacientes con antecedentes personales o familiares de cáncer de piel, debe ser parte de la medicina preventiva. Conclusiones: Los estudios científicos que abordan conocimientos, hábitos y aptitudes en relación con la fotoprotección para la prevención del cáncer de piel, destacan entre sus principales resultados, que la principal conducta para garantizar una adecuada acción protectora saludable es direccionar programas de educación en la prevención primaria de salud.

Foundation: Skin cancer is one of the most common neoplasms, with an increase in the last two decades. Photoprotection campaigns have had a positive impact on the population and allow healthy people to care for their skin and prevent cancer. Objective: To describe the main results obtained in scientific studies related to knowledge, habits and skills in photoprotection for the prevention of skin cancer in a population at risk over 18 years of age. Method: A systematic review was carried out in the databases Scopus and Pubmed in (English), Scielo and CUIDEN in (Spanish), with access profile from the electronic library of the University of Granada in the study period from May 2018 to July 2022. The guiding question was developed through the PICOT acronym, search terms and the descriptors in Health Sciences and Medical Subject Headings were used, respectively. Results: Knowing risk and protective behaviors is useful to guide individual or community-level interventions to reduce morbidity associated with sun exposure. Skin cancer prevention campaigns have been shown to be effective and cost-effective. Primary care physicians play an important role in skin cancer prevention. Counseling on modifiable risk factors and strategies to avoid the sun, in patients with a personal or family history of skin cancer, should be part of preventive medicine. Conclusions: Scientific studies that address knowledge, habits and skills in relation to photoprotection for the prevention of skin cancer, highlight among their main results that the main conduct to guarantee adequate healthy protective action is to direct education programs in primary prevention of health.

Asociación entre edadismo y sexismo en estudiantes universitarios / Association between ageism and sexism in university students

Antecedentes y objetivos El edadismo es la percepción negativa de las personas por su edad. El objetivo de esta investigación fue analizar los niveles de edadismo y su asociación con el sexismo y otros factores en universitarios. Materiales y métodos Se llevó a cabo un estudio transversal a través de una encuesta online entre los estudiantes de la Universidad de Granada (España). Se recogió información sobre variables sociodemográficas y académicas y se administró el Cuestionario de estereotipos negativos hacia la vejez (CENVE), la Escala de sexismo ambivalente (ASI), el Cuestionario breve de los cinco grandes rasgos de personalidad (BFPTSQ), la Escala sobre la ansiedad por el envejecimiento (AE) y la Escala sobre el contacto con personas mayores (CPM). Se determinaron los niveles de edadismo y se exploraron asociaciones con otras variables. A continuación, se realizó un modelo de regresión logística binaria para conocer los factores asociados a su presencia. Resultados Participaron doscientos sesenta y tres (263) estudiantes. La mayoría presentaban niveles de edadismo bajos o muy bajos (83,3%). Los estudiantes más edadistas presentaban mayores niveles de sexismo hostil (OR=1,07; p<0,01) y más ansiedad por el envejecimiento (OR=1,10; p<0,05) que los estudiantes que puntuaron bajo en edadismo. Por otra parte, ser alumno de grado fue un factor protector frente a este tipo de sesgo comparado con la realización de estudios de posgrado (OR=0,31; p<0,05). Conclusión Un mayor sexismo hostil y una mayor ansiedad por el envejecimiento se relacionan con un mayor edadismo en los estudiantes de la Universidad de Granada (España). Las universidades deben brindar conocimiento a sus alumnos sobre este problema y desarrollar programas dirigidos a evitar la discriminación de las personas mayores. (AU)

Background and aims Ageism is the negative perception towards others based on age. The aim of this research was to analyze the levels of ageism and its association with sexism and other factors in university students. Materials and methods Cross-sectional study among the students of the University of Granada. The data was collected through an online survey. Information on sociodemographic and academic variables was collected together with the Negative Stereotypes Questionnaire towards Old Age (CENVE), the Ambivalent Sexism Scale (ASI), the Brief Version of the Big Five Personality Inventory (BFPTSQ), the Anxiety Scale for Aging (AE) and the Contact with the Elderly Scale (CPM). Ageism levels were determined and associations with other variables were analyzed. A logistic regression model explored ageism’ associated factors. Results Two hundred and sixty-three students participated. Most had low or very low levels of ageism (83.3%). The most ageist students showed higher hostile sexism (OR=1.07; p<.01) and higher aging anxiety (OR=1.10; p<.05) than students with high scores in ageism. Graduate students showed protector OR for ageism when compared to postgraduate students (OR=.31; p<.05). Conclusions Higher hostile sexism and aging anxiety are associated with higher ageism in students from the University of Granada. Universities must include in their study plans knowledge about this problem and develop programs aimed at avoiding discrimination in the elderly. (AU)

Asociación entre edadismo y sexismo en estudiantes universitarios / Association between ageism and sexism in university students

Antecedentes y objetivos El edadismo es la percepción negativa de las personas por su edad. El objetivo de esta investigación fue analizar los niveles de edadismo y su asociación con el sexismo y otros factores en universitarios. Materiales y métodos Se llevó a cabo un estudio transversal a través de una encuesta online entre los estudiantes de la Universidad de Granada (España). Se recogió información sobre variables sociodemográficas y académicas y se administró el Cuestionario de estereotipos negativos hacia la vejez (CENVE), la Escala de sexismo ambivalente (ASI), el Cuestionario breve de los cinco grandes rasgos de personalidad (BFPTSQ), la Escala sobre la ansiedad por el envejecimiento (AE) y la Escala sobre el contacto con personas mayores (CPM). Se determinaron los niveles de edadismo y se exploraron asociaciones con otras variables. A continuación, se realizó un modelo de regresión logística binaria para conocer los factores asociados a su presencia. Resultados Participaron doscientos sesenta y tres (263) estudiantes. La mayoría presentaban niveles de edadismo bajos o muy bajos (83,3%). Los estudiantes más edadistas presentaban mayores niveles de sexismo hostil (OR=1,07; p<0,01) y más ansiedad por el envejecimiento (OR=1,10; p<0,05) que los estudiantes que puntuaron bajo en edadismo. Por otra parte, ser alumno de grado fue un factor protector frente a este tipo de sesgo comparado con la realización de estudios de posgrado (OR=0,31; p<0,05). Conclusión Un mayor sexismo hostil y una mayor ansiedad por el envejecimiento se relacionan con un mayor edadismo en los estudiantes de la Universidad de Granada (España). Las universidades deben brindar conocimiento a sus alumnos sobre este problema y desarrollar programas dirigidos a evitar la discriminación de las personas mayores. (AU)

Background and aims Ageism is the negative perception towards others based on age. The aim of this research was to analyze the levels of ageism and its association with sexism and other factors in university students. Materials and methods Cross-sectional study among the students of the University of Granada. The data was collected through an online survey. Information on sociodemographic and academic variables was collected together with the Negative Stereotypes Questionnaire towards Old Age (CENVE), the Ambivalent Sexism Scale (ASI), the Brief Version of the Big Five Personality Inventory (BFPTSQ), the Anxiety Scale for Aging (AE) and the Contact with the Elderly Scale (CPM). Ageism levels were determined and associations with other variables were analyzed. A logistic regression model explored ageism’ associated factors. Results Two hundred and sixty-three students participated. Most had low or very low levels of ageism (83.3%). The most ageist students showed higher hostile sexism (OR=1.07; p<.01) and higher aging anxiety (OR=1.10; p<.05) than students with high scores in ageism. Graduate students showed protector OR for ageism when compared to postgraduate students (OR=.31; p<.05). Conclusions Higher hostile sexism and aging anxiety are associated with higher ageism in students from the University of Granada. Universities must include in their study plans knowledge about this problem and develop programs aimed at avoiding discrimination in the elderly. (AU)

Skin cancer prevention in extreme sports: Intervention in a 24-h race.

INTRODUCTION: Excessive sun exposure and sunburns are the main preventable causes of skin cancer. The growing popularity of outdoor sports in developed countries has motivated the objective of this work to study the risk of photoexposure and the skin cancer prevention needs of athletes in an extreme race and evaluate an intervention targeted at this population. METHODS: An observational study was conducted during the XXIII edition of the 101 km de Ronda race, which consisted of trail running and mountain biking categories. Environmental and personal dosimetry, monitoring of meteorological conditions, evaluation of the athletes' photoprotection and skin examination habits, a dermatological checkup, and a satisfaction questionnaire were performed. RESULTS: The ultra-endurance race was carried out under adverse conditions (maximum ultraviolet index (UVI) = 9.2, temperatures above 30°C, and relative humidity >35%). The mean effective erythema dose received by race athletes (n = 11) was 2959.2 ± 404.2 J/m2 , equivalent to 29.6 standard erythema doses (SED). The CHACES questionnaire (n = 1145) showed a sunburn rate of 58% and poor protective habits: 62.9% of athletes do not usually use sunscreen and 67.2% do not self-examine their skin. Actinic keratoses (4.7%) and suspicious skin cancer lesions (4.2%) were found in dermatologic screening exams (n = 170). On the satisfaction questionnaire (n = 111), this intervention was rated as excellent (95.5%). CONCLUSION: This research highlights the extreme risk of photoexposure that athletes are subjected to during ultra-endurance competitions. In the same way, it shows the need to carry out interventions aimed at the acquisition of healthy photoprotection habits and skin surveillance in this target group.

[Association between ageism and sexism in university students]. / Asociación entre edadismo y sexismo en estudiantes universitarios.

BACKGROUND AND AIMS: Ageism is the negative perception towards others based on age. The aim of this research was to analyze the levels of ageism and its association with sexism and other factors in university students. MATERIALS AND METHODS: Cross-sectional study among the students of the University of Granada. The data was collected through an online survey. Information on sociodemographic and academic variables was collected together with the Negative Stereotypes Questionnaire towards Old Age (CENVE), the Ambivalent Sexism Scale (ASI), the Brief Version of the Big Five Personality Inventory (BFPTSQ), the Anxiety Scale for Aging (AE) and the Contact with the Elderly Scale (CPM). Ageism levels were determined and associations with other variables were analyzed. A logistic regression model explored ageism' associated factors. RESULTS: Two hundred and sixty-three students participated. Most had low or very low levels of ageism (83.3%). The most ageist students showed higher hostile sexism (OR=1.07; p<.01) and higher aging anxiety (OR=1.10; p<.05) than students with high scores in ageism. Graduate students showed protector OR for ageism when compared to postgraduate students (OR=.31; p<.05). CONCLUSIONS: Higher hostile sexism and aging anxiety are associated with higher ageism in students from the University of Granada. Universities must include in their study plans knowledge about this problem and develop programs aimed at avoiding discrimination in the elderly.

Risk assessment of occupational skin cancer among outdoor workers in southern Spain: local pilot study.

OBJECTIVE: Overexposure to ultraviolet (UV) radiation is the main preventable cause of skin cancer. Outdoor workers, exposed to the sun for many hours throughout their working lives, are at special risk. The aim of this study is to determine occupational photoexposure and photoprotection among outdoor workers employed by a municipality in southern Spain. METHODS: Cross-sectional descriptive study focusing on outdoor workers employed by the municipality of Fuengirola (in areas such as construction, gardening, urban cleaning and beach maintenance). The participants were monitored by personal dosimetry, participated in a dermatological check-up and answered a validated questionnaire (CHACES) on their habits, attitudes and knowledge related to sun exposure. RESULTS: The median effective erythema dose of exposure to solar UV radiation during the working day (n=20) was 379.4 J/m2, equivalent to 3.8 standard erythema doses, almost 3 times higher than the recommended limits for an 8-hour workday. Skin examination (n=128) revealed the presence of actinic lentigines (79.7%), actinic keratoses (8.6%) and skin cancer (3.9%). The CHACES questionnaire (n=128) revealed a sunburn rate of 50.0%. Photoprotection practices were markedly deficient: only 16.7% of the survey respondents sought protection in the shade, 20.3% avoided exposure during the peak exposure hours and 33.1% applied sunscreen. CONCLUSIONS: This is the first study to evaluate UV radiation exposure, occupational sun protection practices, sunburn and actinic injuries of different outdoor workers in one of the sunniest regions of Spain and underlines the need for effective interventions to protect outdoor workers' health.

Assessment of hand hygiene strategies on skin barrier function during COVID-19 pandemic: A randomized clinical trial.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) has increased the frequency of handwashing. There is scarce evidence regarding the impact of different hand hygiene procedures on skin barrier function in clinical practice. OBJECTIVE: To compare the impact on skin barrier function of different hand hygiene measures in healthcare workers in daily practice. METHODS: A randomized controlled clinical trial was conducted. Participants were randomized to sanitize their hands with water and soap, alcohol-based hand sanitizers (ABHSs), or disinfectant wipes during their 8-hour working shift. Epidermal barrier functional parameters, such as transepidermal water loss (TEWL), and the microbial load were assessed before and immediately after the working day. Tolerance and acceptability of each product were recorded after work. RESULTS: Sixty-two participants were included and 20, 21, and 21 were randomized to use water and soap, ABHS, and disinfectant wipes, respectively. After the 8-hour shift, TEWL increase was higher with disinfectant wipes than with soaps or ABHS (+5.45 vs +3.87 vs -1.46 g h-1  m-2 , respectively; P = .023). Bacteria and fungi colony-forming unit (CFU) count reductions were lower for the water and soap group than for ABHS and disinfectant wipes. Disinfectant wipes were considered more difficult to use (P = .013) compared with water and soap and ABHS. CONCLUSION: Daily hand hygiene with ABHS showed the lowest rates of skin barrier disruption and the highest reduction of CFU.

Fundamentos teóricos de Florencia Nightingale sobre higiene de manos. Apuntes para una reflexión en tiempos de COVID-19 / Theoretical foundations of Florence Nightingale on hand hygiene. Notes for a reflection in times of COVID-19

RESUMEN Se presenta una revisión, desde el paradigma de Florencia Nightingale, sobre su visión teórica acerca de la higiene de manos. Se analizan los principales aspectos teóricos expresados por ella y su relación con la higiene de manos, además de exponer, mediante el análisis de sus aportes teóricos, su contribución al desarrollo de la enfermería no solo en Cuba sino en el mundo, mostrando la importancia que tiene esta praxis para combatir un sin número de enfermedades infecciosas y muy específicamente la COVID-19, pues una de las medidas más importantes para romper su cadena de transmisión es precisamente la higiene de las manos.

ABSTRACT A review is presented, from the paradigm of Florencia Nightingale, on her theoretical vision about hand hygiene. The main theoretical aspects expressed by her and her relationship with hand hygiene are analyzed, in addition to exposing, through the analysis of her theoretical contributions, her contribution to the development of nursing not only in Cuba but in the world, showing the importance that has this practice to combat a number of infectious diseases and very specifically COVID-19, since one of the most important measures to break its chain of transmission is precisely hand hygiene.

Satisfacción de beneficiarios con la Cooperación Universitaria al desarrollo en seguridad del paciente. Riobamba, 2017 / Satisfaction of patients beneficiated with university cooperation for the development of patient safety in Riobamba, 2017

Introducción: La cooperación universitaria al desarrollo en seguridad del paciente mediante modelos de acreditación y formación sanitaria genera una cultura sanitaria de cuidado que evoluciona hacia mejoras de la atención. Objetivo: Determinar la satisfacción de los beneficiarios directos e indirectos con las acciones instrumentales, técnicas y educativas desarrolladas en el marco del proyecto en Más-Ecuador, cantón Riobamba, 2017. Métodos: Se realizó un estudio descriptivo, transversal, con enfoque mixto. La población fue la totalidad de beneficiarios directos e indirectos que participaron en las actividades de capacitación (348). Se realizó un muestreo no probabilístico que incluyó a aquellos individuos (96) que estuvieron de acuerdo en participar, con edades iguales o superiores a los 20 años, óptimo estado de salud mental y que se encontraban en su ubicación laboral o domiciliar en el momento de aplicación de los instrumentos. Como técnica para la recolección de los datos se empleó un cuestionario diseñado por el equipo investigador, validado durante el proceso investigativo mediante criterio de especialistas. Resultados: Los beneficiaros directos e indirectos del proyecto Más-Ecuador, refirieron un alto nivel de satisfacción general con las acciones instrumentales, técnicas y educativas desarrolladas en el marco de esa intervención; predominando el sexo femenino y la categoría profesional de la salud. Conclusión: Intervenciones como el proyecto Manos Seguras Ecuador (MaS-Ecuador), contribuyen al desarrollo de los procesos formativos en el ámbito académico y comunitario y ayudan a prevenir enfermedades, reducir riesgos en la atención sanitaria, garantizando la seguridad del paciente(AU)

Introduction: University cooperation for the development of patient safety through models of accreditation and health training generates a health culture of care that evolves towards improvements in care. Objective: Determine the satisfaction of direct and indirect beneficiaries with instrumental, technical and educational actions developed within the framework of the MaS-Ecuador project, in Riobamba canton, 2017. Methods: A descriptive, cross-sectional, mixed-focused study was conducted. The population was the total of direct and indirect beneficiaries who participated in the training activities (348). A non-probabilistic sampling was carried out that included those individuals (96) who agreed to participate, at ages equal to or over 20 years, with optimal mental health state and who were in their job or home location at the time of the tools´ application. As a technique for data collection, a questionnaire designed by the research team was used, and it was validated during the research process at the discretion of specialists. Results: The direct and indirect beneficiaries of the MaS-Ecuador project referred to have a high level of general satisfaction with the instrumental, technical and educational actions developed in the framework of this intervention. There was a predominance of the female sex and the category of health professional. Conclusion: Interventions such as the project Manos Seguras Ecuador (MaS-Ecuador) contribute to the development of training processes in the academic and community fields and help to prevent diseases and reduce risks in health care, guaranteeing patient safety(AU)

Higiene de manos en la práctica sanitaria en un contexto local ecuatoriano / Hands hygiene in health practice in a local Ecuadorian context

Las infecciones asociadas con la atención en salud se relacionan a dificultades con la higiene de manos del personal sanitario antes y después de estar en contacto con un paciente. Se reali-zó una investigación descriptiva, con enfoque mixto, con el objetivo de caracterizar la higie-ne de manos en unidades de salud donde realizan práctica formativa y preprofesional los estudiantes de la Facultad de Ciencias de la Salud de la Universidad Nacional de Chimbora-zo, en la ciudad de Riobamba, Ecuador, durante el período comprendido entre septiembre a diciembre de 2017. La población en estudio estuvo conformada por la totalidad de docentes titulares, ocasionales y de apoyo (220) que durante el período de estudio laboraron en el contexto investigado; de la cual, siguiendo un muestreo no probabilístico del tipo intencional, se escogió una muestra de 59 profesores de las unidades docentes asistenciales involucradas. Al indagar el conocimiento que, sobre las principales causas de colonización de gérmenes en el paciente poseen los encuestados, se observó baja percepción referida por los participantes respecto al riesgo de transmisibilidad cruzada a través de las manos y la necesidad de desa-rrollar competencias para la correcta realización de esa técnica. El lavado de manos con base alcohólica, y el tiempo mínimo que dedican los participantes a la fricción de las manos con ese tipo de gel, evidenció que de forma mayoritaria la efectúan por un período de veinte segundos.

Infections associated with health care are related to difficulties with hands hygiene of health personnel before and after being in contact with a patient. A descriptive research with a mixed approach was performed in order to characterize hands hygiene in health units where students of the Faculty of Health Sciences of Universidad Nacional de Chimborazo carry out training and pre-professional practice, during the period September-December 2017. The study population was made up of all of the regular, occasional and support professors (220) who worked in the Faculty of Health Sciences during the study period. 59 teachers from the teaching units involved was chosen by the means of a non-probabilistic sampling of the intentional type. After applying the survey related to the main causes of colonization of germs in the patient, the interviews showed a low perception referred by the participants regarding the risk of cross transmissibility through the hands and the need to develop compe-tences for the correct realization of that technique. The accomplishment of the hand washing with alcoholic base, and the minimum time that the participants dedicated to the friction of the hands with this type of gel evidenced that in a majority way they did it for a period of twenty seconds.

Relación entre cambios en hemoglobina glucosilada y mejora de la composición corporal en pacientes con obesidad mórbida tras gastrectomía tubular laparoscópica / Relationship between changes in hemoglobin glycosilated and improvement of body composition in patients with morbid obesity after tubular laparoscopic gastrectomy

Introducción y objetivo: El objetivo de nuestro estudio es analizar la posible relación entre los cambios en el perfil glucémico y los parámetros de composición corporal en pacientes con obesidad mórbida tras gastrectomía tubular laparoscópica. Material y métodos: Se realiza un estudio observacional prospectivo de cohortes donde el tamaño muestral es de 69 pacientes. Las variables analizadas son peso corporal, glucemia, hemoglobina glucosilada, lipoprotein high density, lipoprotein low density, triglicéridos y circunferencia cintura y cadera. Para llevar a cabo el objetivo de este estudio se ha utilizado un análisis de la variancia de medidas repetidas (ANOVA) y un posterior análisis de correlación a través del test de Pearson. Resultados: Tras el análisis estadístico se han encontrado una reducción significativa del peso tras la cirugía p < 0,001, una reducción significativa de la hemoglobina glucosilada entre los valores preintervención y a los 6 meses de la cirugía (p<0,036) y un descenso significativo de los perímetros de cintura y cadera (p< 0,001). No existieron diferencias significativas en el resto de variables estudiadas. En el análisis de correlación, se encontró una correlación positiva significativa entre el cambio en concentración de hemoglobina glucosilada y perímetro de cadera (p=0,047; r=0,237), a menor diámetro de cadera, menor concentración de hemoglobina glucosilada. Conclusiones: La gastrectomía tubular laparoscópica se muestra como una técnica efectiva para el tratamiento de pacientes obesos mórbidos con diabetes mellitus tipo 2. La reducción en el perímetro de cadera está relacionada con la reducción de hemoglobina glucosilada a los 6 meses de la intervención

Background and objective: The objective of our study is to analyze the possible relationship between changes in glycemic profile and body composition parameters in morbid obesity patients after tubular laparoscopic gastrectomy. Material and methods: A prospective observational cohort study with 69 patients was performed. The variables analyzed were body weight, blood glucose, hemoglobin, glycosylated, high density lipoprotein, low density lipoprotein, triglycerides, and waist and hip circumference. An analysis of variance of repeated measurements (ANOVA) and a correlation analysis through the Pearson test were carried out. Results: A significant reduction in weight (p<.001 after surgery) and in glycosylated hemoglobin (p<.036) and waist hip (p<.001) were found at 6 months after surgery. There was no significant difference in the rest of the variables studied. In correlation analysis, a significant positive correlation was found between the change in concentration of hemoglobin glycosylated and hip circumference (p=.047; r=0.237), the smaller the hip circumference, the lower the concentration of glycosylated hemoglobin. Conclusions: Tubular laparoscopic gastrectomy is an effective technique for the treatment of morbidly obese patients with type 2 diabetes mellitus. The reduction in the perimeter of hip is related to glycosylated hemoglobin reduction 6 months after intervention

Relationship between changes in hemoglobin glycosilated and improvement of body composition in patients with morbid obesity after tubular laparoscopic gastrectomy. / Relación entre cambios en hemoglobina glucosilada y mejora de la composición corporal en pacientes con obesidad mórbida tras gastrectomía tubular laparoscópica.

BACKGROUND AND OBJECTIVE: The objective of our study is to analyze the possible relationship between changes in glycemic profile and body composition parameters in morbid obesity patients after tubular laparoscopic gastrectomy. MATERIAL AND METHODS: A prospective observational cohort study with 69 patients was performed. The variables analyzed were body weight, blood glucose, hemoglobin, glycosylated, high density lipoprotein, low density lipoprotein, triglycerides, and waist and hip circumference. An analysis of variance of repeated measurements (ANOVA) and a correlation analysis through the Pearson test were carried out. RESULTS: A significant reduction in weight (p<.001 after surgery) and in glycosylated hemoglobin (p<.036) and waist hip (p<.001) were found at 6 months after surgery. There was no significant difference in the rest of the variables studied. In correlation analysis, a significant positive correlation was found between the change in concentration of hemoglobin glycosylated and hip circumference (p=.047; r=0.237), the smaller the hip circumference, the lower the concentration of glycosylated hemoglobin. CONCLUSIONS: Tubular laparoscopic gastrectomy is an effective technique for the treatment of morbidly obese patients with type 2 diabetes mellitus. The reduction in the perimeter of hip is related to glycosylated hemoglobin reduction 6 months after intervention.

Use of bone scintigraphy in the early diagnosis of bisphosphonate related osteonecrosis of the jaw. Case report and review of the literature.

The main aim of the present report is to show the potential utility of bone scintigraphy for the diagnosis of jaw osteonecrosis. We report the history of a 62-year-old woman underwent breast cancer surgery in 2010. Moreover, patient received postoperative radiotherapy and chemotherapy. Intravenous bisphosphonates were also added to the treatment strategy to reduce the risk of bone metastasis. However, a hypermetabolic focus on left hemimandible was evidenced with a bone scintigraphy during follow up. After a careful study, the diagnosis of Bisphosphonate Related Ostneonecrosis of the Jaw (BRONJ) was carried out. This case highlights that bone scintigraphy may be extremely helpful for the early detection of BRONJ in high risk patient. Key words:Bone scintigraphy, mandibular osteonecrosis, bisphosphonates.

Plan de cuidados relacionado con el proceso asistencial integrado atención a las perso-nas fumadoras / Care plan related to the integrated healthcare process for smokers

El tabaco es una de las drogas legales más consumidas en el mundo y un importante factor de riesgo de morbi-mortalidad asociado a diferentes enfermedades. Se describe el caso de un paciente que acude a la consulta de enfermería de su centro de salud, detectado como consu-midor de tabaco y captado para realizar un plan de cuidados mediante el Proceso Asistencial Integrado de Atención a Personas Fumadoras. Los principales diagnósticos de enfermería se relacionaron con una tendencia a adoptar conductas de riesgo para la salud, conflicto de deci-siones (dejar de fumar) y disposición para mejorar los conocimientos. Se desarrollaron medi-das como la terapia de grupo, además de la reducción del consumo de nicotina diaria hasta su completa eliminación. Este proceso constituye una herramienta de ayuda para seguir traba-jando en una atención sanitaria centrada en el paciente.

Tobacco is one of the most consumed legal drugs in the world and an important risk factor for morbidity and mortality. The case of a patient who goes to the nursing consultation of a Health Center is described. He was detected as a tobacco consumer and captured to carry out a care plan for the Integrated Healthcare Process for Smokers. The main nursing diagnoses were related to a tendency to adopt risky behaviors for health, conflict of decisions (quit smo-king) and updating to improve knowledge. It was developed group therapy, and reduction of daily nicotine consumption until its complete elimination. This process is a helpful tool to keep working in a patient-centered medical care.Tobacco is one of the most consumed legal drugs in the world and an important risk factor for morbidity and mortality. The case of a patient who goes to the nursing consultation of a Health Center is described. He was detected as a tobacco consumer and captured to carry out a care plan for the Integrated Healthcare Process for Smokers. The main nursing diagnoses were related to a tendency to adopt risky behaviors for health, conflict of decisions (quit smo-king) and updating to improve knowledge. It was developed group therapy, and reduction of daily nicotine consumption until its complete elimination. This process is a helpful tool to keep working in a patient-centered medical care.

Caso relacionado con el proceso asistencial integrado cuidados paliativos en atención primaria de salud / Case related to the integrated palliative care process in primary health care level

La cirrosis hepática constituye una de las principales causas atribuibles a la mortalidad por consumo de alcohol. El caso que se presenta corresponde a un paciente de 58 años diagnosti-cado con dicha enfermedad terminal no oncológica e incluido en el Proceso Asistencial de Cuidados Paliativos, siguiendo una valoración según el modelo conceptual de Virginia Hen-derson y un plan de cuidados según la taxonomía North American Nursing Association, Nur-sing Intervention Classification, Nursing Outcomes Classification. De modo que, las inter-venciones y actividades se basaron principalmente en apoyar emocionalmente tanto al paciente como a la cuidadora principal. El plan de cuidados transita desde su identificación, hasta el cuidado del enfermo en los últimos días de la vida.

Liver cirrhosis is one of the main causes attributable to mortality due to alcohol consumption. The case presented corresponds to a 58-year-old patient diagnosed with this non-oncological terminal disease and included in the Palliative Care Process by following an assessment according to the Virginia Henderson conceptual model and a care plan according to the taxo-nomy North American Nursing Association, Nursing Intervention Classification, Nursing Outcomes Classification. Thus, the interventions and activities were mainly based on suppor-ting emotionally both the patient and the main caregiver. The care plan goes from its identifi-cation to the care of the patient in the last days of life.

Atención a una cuidadora mediante procesos asistenciales integrados / Care for a caregiver through integrated healthcare processes

La población está envejeciendo en los últimos años, y con ello el número de personas depen-dientes, siendo impensable hablar de dependencia sin hablar del cuidador informal. Por lo que, lo/as cuidadores/as han sido incluido/as en los procesos asistenciales integrados para poder conseguir continuidad en los cuidados. De este modo, se presenta el caso clínico de una mujer de 47 años, cuidadora de su suegra, que tras acudir a la consulta de enfermería y reali-zarle una valoración integral, fue diagnosticada de: Cansancio del rol del cuidador y estrés por sobrecarga. Se llevaron a cabo distintas intervenciones que consistían en dar apoyo emo-cional, educación sanitaria y facilitar recursos. Como consecuencia, los resultados fueron satisfactorios, concluyendo que la detección del cansancio del rol de cuidador es crucial por la repercusión que tiene sobre la persona dependiente y el propio cuidador. Palabras clave: cuidadores, planificación de atención al paciente, enfermedad de alzheimer, enfermería en salud comunitaria.

The population is aging in recent years, and with this the number of dependents is too. It is unthinkable to talk about dependence without talking about the informal caregiver. Therefo-re, the caregivers have been included in the integrated healthcare processes in order to achie-ve continuity in care. So, the clinical case of a 47-year-old woman who takes care of her mother-in-law is presented. She was diagnosed with tiredness of the caregiver's role and stress due to overload after attending the nursing consultation and carrying out a comprehen-sive assessment. Different interventions of giving emotional support, health education and facilitating resources were performed. The results were satisfactory, concluding that the detection of tiredness of the role of caregiver is crucial because of the impact it has on the dependent person and the caregiver.

Plan de cuidados sobre un caso relacionado con el proceso asistencial integrado "atención a pacientes pluripatológicos" / Care plan about a case related to the integrated care process "care for multi-pathological patients"

Las enfermedades crónicas son la principal causa de muerte en el mundo, habiendo pacientes con dos o más enfermedades crónicas que precisan de un abordaje sanitario más complejo. Se describe el caso de un paciente pluripatológico que acude a la consulta de enfermería para el seguimiento de sus patologías. Se le realizó un plan de cuidados basado en el Proceso Asistencial Integrado Atención a Pacientes Pluripatológicos. Los principales diagnósticos de enfermería estaban relacionados con el régimen terapéutico y su conducta. Los resultados obtenidos fueron satisfactorios. La labor de la enfermera comunitaria como educadora para la salud es primordial ya que previene la aparición de nuevas patologías y el empeoramiento de las ya existentes.

Chronic diseases are the leading cause of death in the world. Patients with two or more chronic diseases require a more complex sanitary approach. The case of a multi-pathological patient who goes to the nursing consultation for the follow-up of his pathologies is described. A care plan was made based on the Integrated Care Process for multi-pathological patients. The main nursing diagnoses are related to the therapeutic process and its behavior. The results were satisfactory. The work of the community nurse as an educator for health is paramount since it prevents the appearance of new pathologies and the commitment of those already existing.

Efecto de un programa de capacitación en competencias de investigación en estudiantes de ciencias de la salud / Effects of an educational training program on health science students’ research capacity

El Espacio Europeo de Educación Superior implica un cambio en la formación universitaria de Ciencias de la Salud en España. El sistema universitario debe promover desde el grado la adquisición de competencias básicas en investigación, como la gestión de información y la comunicación científica. Este artículo presenta los hallazgos de un estudio cuyo objetivo fue evaluar el nivel de eficacia y satisfacción de un programa de capacitación educativa en competencias de investigación dirigido a estudiantes de Ciencias de la Salud. Se diseñó un estudio cuasiexperimental en el que participaron ciento ocho estudiantes de grado de Fisioterapia, Terapia ocupacional y Enfermería. En una primera fase se detectaron las necesidades educativas en competencias de investigación a través de un cuestionario; a continuación se implementó un programa de capacitación semipresencial y se evaluó el efecto alcanzado en las necesidades antes detectadas. Este programa mejoró significativamente la percepción de los participantes en relación a su conocimiento y habilidad en competencias de investigación. Del mismo modo, las destrezas cognitivas y prácticas mejoraron considerablemente tras el programa. Estos hallazgos evidencian que la puesta en marcha de programas específicos de capacitación en investigación es efectiva para mejorar la adquisición de competencias a este respecto en estudiantes de Ciencias de la Salud (AU)

The European Higher Education Area implies a change to the Health Science education in Spain. Spanish university system must promote the acquisition of competences in research habits, such as the information management or scientific dissemination. This article presents the findings of a study to evaluate the level of effectiveness and satisfaction of an educational training program on research skills geared towards Health Science students. A hundred and eight students of Physical Therapy degree, Occupational Therapy degree and Nursing degree were participated into a quasi-experimental study. Educational needs were first detected by a questionnaire based on different research skills. A semi-distance educational training program was designed and implemented after defining the above-mentioned needs. This program significantly improved the perception of knowledge and skills in research competences. As well as the level of theory and practical content assimilated by the students significantly increased after the program. These findings suggest that incorporation of specific training that allow for students to come in contact with research, are effective at improving research competences for Health Sciences students (AU)